Advanced Urology evaluates and treats pelvic organ prolapse. The practice's own overview is on the official pelvic organ prolapse page, with further reading on learn.advancedurology.com. The notes below are a plain introduction for people we see in Sandy Springs and in intown east Atlanta; the visit is where we fit a plan to you.
What pelvic organ prolapse is
The bladder, uterus, vagina, and rectum are held in place by muscles and connective tissue in the pelvis. When that support stretches or weakens, one or more of those organs can descend and bulge into the vagina, or past the opening. People describe a fullness that worsens as the day goes on, a bulge they can feel or see, or a need to push tissue back in order to empty the bladder or complete a bowel movement.
Different compartments can be involved, and more than one can be involved at the same time:
- Cystocele. The bladder descends into the front wall of the vagina. Incomplete emptying, frequency, urgency, or having to reduce the bulge in order to urinate can come with it.
- Rectocele. The rectum bulges into the back wall of the vagina. Constipation or a need to support the wall during a bowel movement can be part of the picture.
- Enterocele. A loop of bowel bulges into the vaginal wall.
- Uterine prolapse, or vault descent after hysterectomy. The uterus, or the upper vagina after the uterus has been removed, descends into or toward the opening.
What we do at the first visit
Women can begin at our Sandy Springs Clinic & Surgery Center, 1450 S Johnson Ferry Road, or at our Decatur Clinic, 2711 Irvin Way. At Sandy Springs, the official office page names our urologists and the family nurse practitioner and physician assistants who work with them. At Decatur, the official office page names physician assistants on the on-site team, who work inside the same practice chart. Tell us when you book if you would like a urologist for the first visit, and we will look at the Sandy Springs schedule.
We will ask how long the pressure or bulge has been present, what makes it better or worse, and how it has changed urination, bowel habits, or intimacy. An exam is often part of that first visit. Additional testing, when it would change the plan, may include a look at how the bladder stores and empties, or a look inside the bladder. We explain any test before it is scheduled.
How care is usually discussed
Not every woman with prolapse needs a procedure. The first conversation is about your goals: comfort, emptying, intimacy, and what you hope will change. Daily habits, pelvic floor work, and a supportive device can be part of the discussion. When a repair is a reasonable next step, we will talk through the surgical approaches listed on the official prolapse page, including vaginal repairs and repairs done with laparoscopic or robotic instruments. We will tell you whether a planned procedure would be scheduled at our Sandy Springs surgery center or at another Advanced Urology surgery center, and how to prepare. We do not use this page to promise a particular operation, a particular recovery length, or a particular outcome; those answers belong in your visit.
Related concerns — leakage, urgency, or incomplete emptying — are often part of the same story. See our pages on urology care for women, bladder leakage, and overactive bladder.
Questions women ask about prolapse
Is a bulge always an emergency?
A bulge or pelvic pressure that you can plan a visit around belongs in clinic, not in an emergency department. Go to an emergency department or call 911 if you cannot pass urine, if bleeding is heavy, or if you have a high fever with pain. For a planned review of symptoms that have been building, call 678-344-8900 and we will get you on the schedule at Sandy Springs or Decatur.
Can I start at the Decatur clinic?
Yes. Many women begin at 2711 Irvin Way for the conversation and the exam. If a procedure is later recommended, we schedule it at a surgery center in the practice, commonly Sandy Springs or Snellville, and your chart travels with you.
Do I need a referral?
You can usually call us directly. A few insurers want a primary-care referral on file, so check yours. Bring a government-issued identification, insurance information if you carry it, a medicine list, and any pelvic imaging you already have.